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2.
J Clin Transl Sci ; 4(3): 201-208, 2020 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-32695489

RESUMO

A primary barrier to translation of clinical research discoveries into care delivery and population health is the lack of sustainable infrastructure bringing researchers, policymakers, practitioners, and communities together to reduce silos in knowledge and action. As National Institutes of Health's (NIH) mechanism to advance translational research, Clinical and Translational Science Award (CTSA) awardees are uniquely positioned to bridge this gap. Delivering on this promise requires sustained collaboration and alignment between research institutions and public health and healthcare programs and services. We describe the collaboration of seven CTSA hubs with city, county, and state healthcare and public health organizations striving to realize this vision together. Partnership representatives convened monthly to identify key components, common and unique themes, and barriers in academic-public collaborations. All partnerships aligned the activities of the CTSA programs with the needs of the city/county/state partners, by sharing resources, responding to real-time policy questions and training needs, promoting best practices, and advancing community-engaged research, and dissemination and implementation science to narrow the knowledge-to-practice gap. Barriers included competing priorities, differing timelines, bureaucratic hurdles, and unstable funding. Academic-public health/health system partnerships represent a unique and underutilized model with potential to enhance community and population health.

3.
J Community Health ; 43(3): 552-559, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29196902

RESUMO

The high prevalence of health disparity diseases (e.g., obesity, Type 2 diabetes) among underserved populations in the United States suggests the need for increased resources to prevent these diseases and to improve health care access and quality in underserved communities. Community health workers are valuable resources and facilitators of health care access and quality treatment. The purpose of the present study is to provide descriptive information about community health workers in Florida and to provide recommendations for improved training and expansion of community health workers' roles in research and intervention. The study participants were 396 adults (85.1% Female, 75.5% Community health workers) who completed the 2015 Florida Community Health Workers Census. Participants were recruited by the Health Council of South Florida through emails and phone calls to members of the Florida Community Health Worker Coalition and various organizations. It was found that several groups disproportionately affected by health disparities were underrepresented among the community health workers who participated in the census and among the communities served by these community health workers. Actions are needed to improve and increase the recruitment and training of community health workers in Florida.


Assuntos
Agentes Comunitários de Saúde , Adulto , Agentes Comunitários de Saúde/educação , Agentes Comunitários de Saúde/organização & administração , Agentes Comunitários de Saúde/estatística & dados numéricos , Feminino , Florida , Humanos , Masculino , Área Carente de Assistência Médica , Seleção de Pessoal
4.
J Womens Health (Larchmt) ; 25(9): 944-51, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-26890012

RESUMO

OBJECTIVES: Women in safety-net institutions are less likely to receive cervical cancer screening. Human papilloma virus (HPV) self-sampling is an alternative method of cervical cancer screening. We examine the acceptability and feasibility of HPV self-sampling among patients and clinic staff in two safety-net clinics in Miami. MATERIALS AND METHODS: Haitian and Latina women aged 30-65 years with no Pap smear in the past 3 years were recruited. Women were offered HPV self-sampling or traditional Pap smear screening. The acceptability of HPV self-sampling among patients and clinic staff was assessed. If traditional screening was preferred the medical record was reviewed. RESULTS: A total of 180 women were recruited (134 Latinas and 46 Haitian). HPV self-sampling was selected by 67% women. Among those selecting traditional screening, 22% were not screened 5 months postrecruitment. Over 80% of women agreed HPV self-sampling was faster, more private, easy to use, and would prefer to use again. Among clinic staff, 80% agreed they would be willing to incorporate HPV self-sampling into practice. CONCLUSIONS: HPV self-sampling was both acceptable and feasible to participants and clinic staff and may help overcome barriers to screening.


Assuntos
Detecção Precoce de Câncer/métodos , Programas de Rastreamento/métodos , Infecções por Papillomavirus/diagnóstico , Autocuidado/métodos , Manejo de Espécimes/métodos , Neoplasias do Colo do Útero/diagnóstico , Adulto , Idoso , Feminino , Florida , Haiti/etnologia , Hispânico ou Latino , Humanos , Pessoa de Meia-Idade , Teste de Papanicolaou , Papillomaviridae/isolamento & purificação , Aceitação pelo Paciente de Cuidados de Saúde , Provedores de Redes de Segurança , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologia , Esfregaço Vaginal
5.
Trials ; 15: 299, 2014 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-25056208

RESUMO

BACKGROUND: In the United States certain minority groups, such as racial/ethnic immigrant women, are less likely than non-Hispanic White women to be screened for cervical cancer. Barriers to such care include health insurance, cost, knowledge, attitudes, health literacy, and cultural norms and practices. Among the most promising approaches to increase screening in these groups are patient navigators that can link women to sources of appropriate care. Another recent promising approach is using human papilloma virus (HPV) self-sampling. In this manuscript, we describe our National Cancer Institute-sponsored study testing such approaches among immigrant minority women. DESIGN: The South Florida Center for the Reduction of Cancer Health Disparities (SUCCESS) is conducting a three-arm randomized trial among Hispanic, Haitian, and African American women in Miami-Dade County. Community health workers (CHW) based in each of three communities are recruiting 200 women at each site (600 total). Eligibility criteria include women aged 30-65 years who have not had a Pap smear test in the last 3 years. Prior to randomization, all women undergo a standardized structured interview. Women randomized to public health outreach, Group 1, receive culturally tailored educational materials. Women in Group 2 receive an individualized comprehensive cervical cancer CHW-led education session followed by patient navigation to obtain the Pap smear test at community-based facilities. Women in Group 3 have the option of navigation to a Pap smear test or performing HPV self-sampling. The primary outcome is self-report of completed screening through a Pap smear test or HPV self-sampling within 6 months after enrollment. DISCUSSION: SUCCESS is one of the first trials testing HPV self-sampling as a screening strategy among underserved minority women. If successful, HPV self-sampling may be an important option in community outreach programs aimed at reducing disparities in cervical cancer. TRIAL REGISTRATION: Clinical Trials.gov # NCT02121548, registered April 21, 2014.


Assuntos
Protocolos Clínicos , Disparidades em Assistência à Saúde , Projetos de Pesquisa , Neoplasias do Colo do Útero/prevenção & controle , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Papillomaviridae/isolamento & purificação , Tamanho da Amostra
6.
Am J Clin Nutr ; 99(6): 1487-98, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24760972

RESUMO

BACKGROUND: Hispanics are a heterogeneous group of individuals with a variation in dietary habits that is reflective of their cultural heritage and country of origin. It is important to identify differences in their dietary habits because it has been well established that nutrition contributes substantially to the burden of preventable diseases and early deaths in the United States. OBJECTIVE: We estimated the distribution of usual intakes (of both food groups and nutrients) by Hispanic and Latino backgrounds by using National Cancer Institute methodology. DESIGN: The Hispanic Community Health Study/Study of Latinos is a population-based cohort study that recruited participants who were 18-74 y of age from 4 US cities in 2008-2011 (Miami, Bronx, Chicago, and San Diego). Participants who provided at least one 24-h dietary recall and completed a food propensity questionnaire (n = 13,285) were included in the analyses. Results were adjusted for age, sex, field center, weekend, sequencing, and typical amount of intake. RESULTS: Overall, Cubans (n = 2128) had higher intakes of total energy, macronutrients (including all subtypes of fat), and alcohol than those of other groups. Mexicans (n = 5371) had higher intakes of vitamin C, calcium, and fiber. Lowest intakes of total energy, macronutrients, folate, iron, and calcium were reported by Dominicans (n = 1217), whereas Puerto Ricans (n = 2176) had lowest intakes of vitamin C and fiber. Food-group servings reflected nutrient intakes, with Cubans having higher intakes of refined grains, vegetables, red meat, and fats and Dominicans having higher intakes of fruit and poultry, whereas Puerto Ricans had lowest intakes of fruit and vegetables. Central and South Americans (n = 1468 and 925, respectively) were characterized by being second in their reported intakes of fruit and poultry and the highest in fish intake in comparison with other groups. CONCLUSION: Variations in diet noted in this study, with additional analysis, may help explain diet-related differences in health outcomes observed in Hispanics and Latinos.


Assuntos
Doença Crônica/epidemiologia , Dieta/efeitos adversos , Ingestão de Energia , Promoção da Saúde , Disparidades nos Níveis de Saúde , Cooperação do Paciente , Saúde da População Urbana , Adolescente , Adulto , Idoso , American Heart Association , Doença Crônica/etnologia , Doença Crônica/prevenção & controle , Estudos de Coortes , Dieta/etnologia , Ingestão de Energia/etnologia , Comportamento Alimentar/etnologia , Feminino , Seguimentos , Hispânico ou Latino , Humanos , Masculino , Pessoa de Meia-Idade , Política Nutricional , Inquéritos Nutricionais , Prevalência , Fatores de Risco , Estados Unidos/epidemiologia , Saúde da População Urbana/etnologia , Adulto Jovem
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